Optimal technique factors for magnification mammography.

Rationale and Objectives: Use of small focal spots with low x-ray tube currents may result in very long exposure times and thus result in motion blur in magnification mammography. The authors investigated the reduction in exposure time with increasing x-ray tube kVp and the corresponding decrease in perceived visibility of low-contrast objects in phantom images.
Methods: Exposure times required to radiograph an RMI 156 phantom in a magnification geometry were measured as a function of x-ray tube kVp when operated under automatic exposure control. Magnification images of the RMI 156 phantom were obtained at x-ray tube voltages ranging from 28 to 34 kVp. Five radiology residents ranked the visibility of two borderline fibers and six borderline microcalcification specks using a 5-point scale ranging from excellent to barely visible.
Results: Between 28 and 34 kVp, the density of the RMI phantom images was nearly constant with a mean value of 1.32 +/- 0.04. Increasing the x-ray tube voltage from 28 kVp to 34 kVp reduced the exposure time from 1.27 seconds to 0.66 seconds. Image quality at 30 and 32 kVp was not significantly worse than that achieved at 28 kVp. Increasing the x-ray tube voltage to 34 kVp, however, resulted in a statistically significant (P < 0.001) deterioration in the relative visibility of fibers and microcalcification specks.
Conclusions: Magnification mammography performed at 32 kVp will decrease exposure times significantly and result in a microcalcification and fiber visibility that is similar to that achieved at 28 kVp.